Members of our team had the opportunity to present a new poster abstract, "Providers' Knowledge and Perceptions Regarding Basal-Bolus Insulin Therapy Utilization in Acute Care Settings", at the ASHP 2024 Midyear Meeting held December 8 - 12, 2024.

Authors:

Madison Campbell, PharmD | Casey Fitzpatrick, PharmD, BCPS | Gretchen Lindsey, PharmD

Background:

High glycemic variability in hospitalized patients is linked to adverse health outcomes and higher healthcare costs.

Glycemic variability includes both hyperglycemic and hypoglycemic episodes, which post serious risks in acute and behavioral health settings.

• Hypoglycemia (blood glucose <70 mg/dL) can lead to symptoms like shakiness, dizziness, cognitive impairment, and even mortality.
• Hyperglycemia (blood glucose >140 mg/dL) can cause complications such as infections, delayed wound healing, and cardiovascular events.¹ 

Effective glycemic management is essential for optimal patient outcomes and reduced healthcare costs.

Hypo- and hyperglycemic events impact hospital reimbursement and public perception as CMS requires hospitals to report severe events are preventable harms.

• Hypoglycemic events occur when blood glucose is <40 mg/dL following hypoglycemic medication.
• Hyperglycemic events occur when blood glucose is >300 mg/dL on any given day or elevated over consecutive days without measurement.¹

Current Research: 

• The NICE-SUGAR trial showed that intensive glucose control in critically ill patients did not reduce mortality, but it did increase hypoglycemia risk, influencing current management practices.
• Basal-bolus insulin regimens are effective for managing inpatient blood glucose levels.
• The RABBIT 2 trial demonstrated basal-bolus insulin improves glycemic control compared to sliding scale insulin alone.³

Investigating real-world practices and perceptions can provide insights into the challenges and factors influencing the use of basal-bolus insulin, helping to optimize diabetes care and inform guidelines.

Primary Objective:

• To evaluate the knowledge and perceptions of basal-bolus insulin therapy among providers practicing in acute care settings, focusing on their understanding of its clinical guidelines and application in patient management.
  
  

Secondary Objectives:

• To examine perceived barriers and challenges faced by providers in the consistent implementation and utilization of basal-bolus insulin therapy within acute care settings.
• To evaluate the impact of provider knowledge on the quality of glycemic control achieved in hospitalized patients.
  

Read about the team's findings by downloading the outcomes study below.